Kentucky SB 103

Amend KRS 304.17A-164 to define terms; prohibit insurers and administrators from requiring insureds to pay cost sharing for a prescription drug that is greater than the cash price; require insurers and administrators to count the amount paid for a covered prescription drug towards the insured's cost-sharing if certain requirements are met; establish requirements for insurers, administrators, and pharmacies for submission of cash price paid by an insured; exempt a state employee health plan from counting third-party payments unless a cash price was paid that is less than the plan's negotiated price; provide for construction of cost-sharing requirements; amend KRS 304.17C-125, 304.38A-115, 164.2871, and 18A.225 to apply cost-sharing requirements to limited health plans, self-insured state postsecondary education institution employer group health plans, and the state employee health plan; create a new section of KRS Chapter 315 to require pharmacies to comply with cost-sharing requirements; provide that cost-sharing requirements apply to health plans issued or renewed on or after effective date; EFFECTIVE, January 1, 2027.